Kidney stones are hard masses that are formed due to deposition of minerals and salts in the kidneys. These stones are formed when there is an excess of such stone-forming minerals or if the urine is not dilute enough. This allows such salts and minerals to crystallize into solid deposits and stick together. Kidney stones form in the kidneys but can affect any part of the urinary system (kidneys, ureters, urinary bladder).
Passing kidney stones through urination can be quite painful if they are large in size. If treated on time, kidney stones as such do not cause any serious health complications, otherwise, they can lead to various kinds of infections. Doctors often recommend preventive measures to those who have already suffered from stones as such people are at risk of recurrence.
Causes of kidney stones
Kidney stones are not attributed to any specific causes. They result due to a combination of several factors. When the urine contains stone-forming substances such as calcium, uric acid, and oxalate in quantities higher than what the water in the urine can dilute, it results in the formation of stones. Additionally, the urine may lack compounds that hinder the formation of stones.
Symptoms of kidney stones
Kidney stones by themselves may not be symptomatic until they leave the kidneys. Once they pass into the ureters (the tubes connecting the kidney to the bladder), they may cause the following symptoms-
- Intense pain below the ribs and at the back.
- Intense pain that spreads to the lower abdomen and the groin.
- Fluctuating pains that come in waves.
- Pain during urination.
- Pink, red or brown coloured urine.
- Blood in urine.
- Cloudy or extremely foul-smelling urine.
- A continuous urge to urinate.
- Urinating far more often than usual.
- Urinating in small quantities.
- Fever and chills, if the stone has caused infection.
The pain that is caused by kidney stone often changes with the movement of the stone through the urinary tract.
Types of kidney stones
Depending upon the type of kidney stone, one may be able to identify the causes that led to its formation and suggest preventive measures. Medical practitioners often advise patients to save their kidney stones for identification and analysis. The various types of kidney stones are-
- Calcium stones– Calcium stones are the most popular kind of kidney stone and they exist in the form of calcium oxalate and calcium phosphate. Oxalate is found in a number of food items such as fruits, nuts vegetables, and chocolates. Added to this, the liver also makes oxalate on a regular basis. Factors that result in high levels of oxalate and calcium in the body are consumption of high quantities of vitamin D, other dietary factors, intestinal bypass surgery and various kinds of metabolic disorders. Calcium phosphate is usually common in patients with metabolic disorders such as renal tubular acidosis, migraines and certain types of seizure medications like topiramate.
- Struvite stones- These stones are usually the result of certain type infections such as urinary tract infection. They can quickly increase in size with little to no signs or symptoms.
- Uric acid stones- Happens in patients who do not consume enough water, lose too much fluid, have gout or are on a high-protein diet. Certain genetic factors are also tied to the formation of uric acid stones.
- Cystine stones- Cystine stones happen in patients with a genetic disorder that causes them to pass excess of a certain type of amino acid while urinating. The condition is known as Cystinuria.
Risk factors associated with kidney stones
There are various risk factors that are linked to the development of kidney stones-
- If there’s a history of kidney stones in the patient’s family, then the patient is more likely to develop stones themselves. Additionally, if the patient has had kidney stones in the past, then there is an increased risk of recurrence.
- Dehydration is another risk factor for kidney stones. People who live in warm climates and sweat a lot are at an increased risk of developing kidney stones.
- Certain kinds of diets such as high-protein diet and especially high-sodium diet increase calcium in the kidneys. This is a significant contributor to the development of stones in kidneys.
- Obesity and excessively high BMI increases the risk of developing stones in the kidney.
- Certain diseases such as inflammatory bowel disease and chronic diarrhea change the ability of intestines to absorb water and calcium leading to higher levels of stone-forming substances in the kidney. The same is true for surgeries like gastric bypass surgery.
- Certain diseases also increase the risk of kidney stones such as cystinuria, renal tubular acidosis, UTI and hyperparathyroidism.
Diagnosis of kidney stones
The various diagnostic procedures used for identifying kidney stones are mentioned below.
- Blood tests- Blood tests show the levels of calcium and uric acid in the body and also reveals details about the health of kidneys.
- Urine tests- 24-hour urine collection test gives information about the amount of stone-forming substances and levels of stone preventing compounds in the urine.
- Imaging techniques- X-rays are effective at revealing large stones and for small stones, CT scans, ultrasound, and intravenous urography are used.
- Collecting passed stones- Doctors often ask their patients to urinate through a strainer in order to collect the passed stones for analysis. Subsequent lab tests reveal the composition of the stones and help in planning for the right treatment and prevention method.
Treatment of kidney stones
The treatment method for kidney stones depends on their size and cause. For kidney stones that are small in size and are without any major symptoms, drinking enough water and taking pain relievers often prove sufficient. Other medications such as alpha blockers may be prescribed by the doctor. This helps in relaxing the muscles in the ureters and allows the small stones to pass without much pain. Some of the various treatment methods for large, symptomatic kidney stones are-
- Using sound waves- Depending upon the size and location, high-frequency vibrations are used to break up large stones which can then be passed harmlessly through urination. This process is also known as extracorporeal shock wave lithotripsy (ESWL).
- Surgery- A surgical process known as percutaneous nephrolithotomy is used when ESWL fails to remove large kidney stones. The process involves making a small incision at the back and removing the stones using small telescopic devices and other instruments.
- Parathyroid gland surgery- Certain types of calcium phosphate stones are caused by an overactive parathyroid gland. When these glands produce too much hormone, it causes the calcium levels in the bloodstream to rise. This often happens when small benign tumors grow on these glands. Surgically removing these tumors or undergoing treatments that stop the overproduction of hormones help in bringing down the calcium levels in the blood.
Kidney stones can be easily prevented by making some simple lifestyle choices. Some healthy lifestyle changes that can help in bringing down the risk of kidney stones include drinking enough water, consuming less oxalate-rich foods, low-salt and low animal protein diet and avoiding calcium supplements when not necessary. If kidney stones still develop despite such healthy habits then its best to consult a urologist. Here at mfine, you can consult with top urologists from the best hospitals in the country. Download the mfine app and begin an online consultation from the comfort of your home, the minute you need one!